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Treatment of a intracranial stenosis with a vulnerable plaque under proximal flow reversal with balloon angioplasty and stent placement
  1. Michael C Gao1,
  2. Joseph J Gemmete2,
  3. Aditya S Pandey3,
  4. Neeraj Chaudhary2
  1. 1Medical School, University of Michigan, Ann Arbor, Michigan, USA
  2. 2Department of Radiology, Division of Interventional Neuroradiology, University of Michigan, Ann Arbor, Michigan, USA
  3. 3Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA
  1. Correspondence to Dr Joseph J Gemmete, Department of Interventional Neuroradiology, University of Michigan, 1500 E Medical Center Drive, UH B1 D328, Ann Arbor, Michigan 48109-5030, USA; gemmete{at}med.umich.edu

Abstract

Intracranial stenosis is associated with a high risk of ischemic events, even with medical treatment. Percutaneous transluminal angioplasty and stenting (PTAS) is an accepted intervention for addressing a moderate intracranial stenosis (≥50%) that is refractory to medical treatment. Distal emboli are seen in 34% to 70% of patients on MRI diffusion weighted images post PTAS. We present a unique case of an intracranial stenosis with a vulnerable plaque treated with PTAS under proximal flow reversal to decrease the risk of possible distal embolization.

  • Angiography
  • stent
  • balloon
  • blood flow
  • stenosis, aneurysm
  • arteriovenous malformation
  • CT angiography
  • vascular malformation

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Footnotes

  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.